Educators’ perceptions of organisational readiness for implementation of a pre-adolescent transdisciplinary school health intervention for inter-generational outcomes

Autoři: Keshni Arthur aff001;  Nicola Christofides aff001;  Gill Nelson aff001
Působiště autorů: School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa aff001;  UCL Institute for Global Health, University College London, London, United Kingdom aff002
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0227519


Organisational readiness is an implementation pre-requisite to gain its members' appropriate and committed use of the intervention. Implementation climate and organisational readiness for implementing change were evaluated conjointly to assess organisational readiness for an obesity and HIV health intervention that imparts health information directly to Grade 6 learners, and indirectly to their parents/caregivers in their home environment. The study objectives were to assess the level of organisational readiness at schools and to identify organisational factors (facilitators, barriers and contextual factors). A mixed-methods approach collected data from five public schools in Gauteng, South Africa. Forty-six educators and school management answered a self-administered questionnaire and contributed to a focus group discussion at each school. Mean scores with standard deviations, or median scores with interquartile ranges, were calculated to determine levels of organisational readiness. Qualitative data were transcribed and analysed thematically. The overall implementation climate and organisational readiness for implementing change median scores were acceptable, at 3.6 (IQR 3.2–4.1) and 4.3 (IQR 3.8–4.9), respectively. Results indicated that educators collectively valued the change highly enough to commit to its implementation, and that the motivation for the intervention, associated goals and objectives, the realisation for change, and the benefits thereof were well-comprehended by educators. Thirteen barriers and 13 facilitators were identified. The perceived degree of fit between the significance and values attached to the intervention by educators, and how these would be received by the target group (parents and learners) was also beneficial. Key barriers and facilitators indicated that the intervention needed to be a fit with existing workflows and educational systems. Contextual factors such as intervention appropriateness and acceptability as well as sensitivity to HIV were identified. These findings suggested proactive improvements to further improve the intervention and its implementation strategy.

Klíčová slova:

Education – Educational attainment – Health education and awareness – Human learning – Children – Learning – Schools – Teachers


1. Scaccia Jonathan P., Cook Brittany S., Lamont Andrea, Wandersman Abraham, Castellow Jennifer and JK. A practical imlementation science heuristic for organisational readiness: R = MC2. J Community Psychol. 2015;43: 484–501. doi: 10.1002/jcop.21698 26668443

2. Weiner BJ. A theory of organizational readiness for change. Implement Sci. 2009;4. doi: 10.1186/1748-5908-4-67 19840381

3. Stokols D. Toward a science of transdisciplinary action research. Am J Community Psychol. 2006;38: 63–77. doi: 10.1007/s10464-006-9060-5 16791514

4. Pillay-van Wyk V, Msemburi W, Laubscher R, Dorrington RE, Groenewald P, Glass T, et al. Mortality trends and differentials in South Africa from 1997 to 2012: second National Burden of Disease Study. Lancet Glob Heal. 2016;4: e642–e653. doi: 10.1016/S2214-109X(16)30113-9

5. Devanathan R, Esterhuizen TM, Govender RD. Overweight and obesity amongst Black women in Durban, KwaZulu-Natal: A “disease” of perception in an area of high HIV prevalence. African J Prim Heal Care Fam Med. 2013;5: 1–7. doi: 10.4102/phcfm.v5i1.450

6. Averett SL, Stacey N, Wang Y. Decomposing race and gender differences in underweight and obesity in South Africa. Econ Hum Biol. 2014;15: 23–40. doi: 10.1016/j.ehb.2014.05.003 25434513

7. Damerell P, Howe C, Milner-Gulland EJ. Child-orientated environmental education influences adult knowledge and household behaviour. Environ Res Lett. 2013;8: 015016. doi: 10.1088/1748-9326/8/1/015016

8. NIH Fogarty International Center. Implementation science information and resources. 2017 [cited 14 Sep 2017]. Available:

9. Grimshaw JM, Eccles MP, Lavis JN, Hill SJ, Squires JE. Knowledge translation of research findings. Implement Sci. 2012;7: 1. doi: 10.1186/1748-5908-7-50 22651257

10. Klein KJ, Sorra JS. The Challenge of Innovation Implementation. Acad Manag Rev. 2008;21: 1055–1080.

11. Weiner B, Lewis M, Linnan L. Using organization theory to understand the determinants of effective implementation of worksite health promotion programs. Health Educ Res. 2009;24: 292–305. doi: 10.1093/her/cyn019 18469319

12. Ehrhart MG, Torres EM, Wright LA, Martinez SY, Aarons GA. Validating the Implementation Climate Scale (ICS) in child welfare organizations. Child Abus Negl. 2016;53: 17–26. doi: 10.1016/j.chiabu.2015.10.017 26563643

13. Storkholm MH, Mazzocato P, Tessma MK, Savage C. Assessing the reliability and validity of the Danish version of Organizational Readiness for Implementing Change (ORIC). Implement Sci. 2018;13: 1–7. doi: 10.1186/s13012-017-0699-0

14. Shea CM, Jacobs SR, Esserman DA, Bruce K, Weiner BJ. Organizational readiness for implementing change: a psychometric assessment of a new measure. Implement Sci. 2014;9: 7. doi: 10.1186/1748-5908-9-7 24410955

15. Ehrhart MG, Aarons GA, Farahnak LR. Assessing the organizational context for EBP implementation: the development and validity testing of the Implementation Climate Scale (ICS). Implement Sci. 2014;9: 157. doi: 10.1186/s13012-014-0157-1 25338781

16. Lyon AR, Cook CR, Brown EC, Locke J, Davis C, Ehrhart M, et al. Assessing organizational implementation context in the education sector: confirmatory factor analysis of measures of implementation leadership, climate, and citizenship. J Implement Sci. 2018;13: 1–14. doi: 10.1186/s13012-017-0705-6 29310673

17. Hamilton S, McLaren S, Mulhall A. Assessing organisational readiness for change: Use of diagnostic analysis prior to the implementation of a multidisciplinary assessment for acute stroke care. Implement Sci. 2007;2: 1–11. doi: 10.1186/1748-5908-2-1

18. Hagedorn HJ, Heideman PW. The relationship between baseline Organizational Readiness to Change Assessment subscale scores and implementation of hepatitis. Implement Sci. 2010;5. Available:

19. Nilsen P, Wallerstedt B, Behm L, Ahlström G. Towards evidence-based palliative care in nursing homes in Sweden: A qualitative study informed by the organizational readiness to change theory. Implement Sci. 2018;13: 1–12. doi: 10.1186/s13012-017-0699-0 29301543

20. Lynch D, Smith R, Yeigh T, Provost S. A study into “organisational readiness” and its impacts on school improvement. Int J Educ Manag. 2019;33: 393–408. doi: 10.1108/IJEM-07-2017-0181

21. Oterkiil C, Ertesvåg SK. Schools’ readiness and capacity to improve matter. Educ Inq. 2014;3: 71–92. doi: 10.3402/edui.v3i1.22014

22. Gugglberger L, Dür W. Capacity building in and for health promoting schools: Results from a qualitative study. Health Policy (New York). 2011;101: 37–43. doi: 10.1016/j.healthpol.2010.08.019 20855125

23. Gregory A, Henry DB, Schoeny ME, Eron L, Guerra N, Henry D, et al. School climate and implementation of a preventive intervention. Am J Community Psychol. 2007;40: 250–260. doi: 10.1007/s10464-007-9142-z 17917806

24. Naylor PJ, Nettlefold L, Race D, Hoy C, Ashe MC, Wharf Higgins J, et al. Implementation of school based physical activity interventions: A systematic review. Prev Med (Baltim). 2015;72: 95–115. doi: 10.1016/j.ypmed.2014.12.034 25575800

25. Schaap R, Bessems K, Otten R, Kremers S, van Nassau F. Measuring implementation fidelity of school-based obesity prevention programmes: A systematic review. Int J Behav Nutr Phys Act. 2018;15. doi: 10.1186/s12966-018-0709-x 30103764

26. Zhang W, Creswell J. The use of mixing procedure of mixed methods in health services research. Med Care. 2013;51: 51–57. doi: 10.1097/MLR.0b013e31824642fd 23860333

27. The Government Gazette. The national norms and standards for school funding. Pretoria; 2006.

28. Gardiner M. Priority Areas for Educational Attention in South Africa by Michael Gardiner. Johannesburg; 2006.

29. Pinnock H, Barwick M, Carpenter CR, Eldridge S, Grandes G, Griffiths CJ, et al. Standards for Reporting Implementation Studies (StaRI) Statement. BMJ. 2017;356. doi: 10.1136/bmj.i6795 28264797

30. Erlingsson C, Brysiewicz P. A hands-on guide to doing content analysis. African J Emerg Med. 2017;7: 93–99. doi: 10.1016/j.afjem.2017.08.001 30456117

31. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3: 77–101. doi: 10.1191/1478088706qp063oa

32. Weiner BJ, Belden CM, Bergmire DM, Johnston M. The meaning and measurement of implementation climate. Implement Sci. 2011;6: 1–12. doi: 10.1186/1748-5908-6-1

33. Mangwaya E, Blignaut S, Pillay SK. The readiness of schools in Zimbabwe for the implementation of early childhood education. South African J Educ. 2016;36: 1–8. doi: 10.15700/saje.v36n1a792

34. Klein K, Conn A, Smith D, Sorra J. Is everyone in agreement? An exploration of within-group agreement in employee perceptions of the work environment. J Appl Soc Psychol. 2001;86: 11302231.

35. Harper GW, Neubauer LC, Francisco VT. Transdisciplinary Research and Evaluation for Community Health Initiatives. NIH Public Access. 2010;9: 328–337. doi: 10.1177/1524839908325334 18936267

Článek vyšel v časopise


2020 Číslo 1